GREAT LAKES PEDIATRIC CARDIOLOGY, PLLC
NPI 1972293967
Pediatrics - Pediatric Cardiology in Sterling Heights, MI
About Great Lakes Pediatric Cardiology, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GREAT LAKES PEDIATRIC CARDIOLOGY, PLLC (NPI 1972293967) is a healthcare organization registered as a pediatric cardiology in Sterling Heights, Michigan and active in the NPI registry since May 2023. The organization lists Ismael Gonzalez Rangel, Pediatric Cardiologist, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 2
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Great Lakes Pediatric Cardiology, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Great Lakes Pediatric Cardiology, PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Great Lakes Pediatric Cardiology PLLC's NPI number?
The NPI number for Great Lakes Pediatric Cardiology PLLC is 1972293967. It was assigned to this organization in the NPPES registry on May 11, 2023. The provider is doing business as Great Lakes Pediatric Cardiology, PLLC and Great Lakes Pediatric Cardiology.
Where is Great Lakes Pediatric Cardiology PLLC located?
Great Lakes Pediatric Cardiology PLLC is located at 43200 Dequindre Rd Ste 105, Sterling Heights, MI 48314. The listed phone number is (248) 780-9490.
What is Great Lakes Pediatric Cardiology PLLC's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.
Is Great Lakes Pediatric Cardiology PLLC enrolled in Medicare?
Yes. Great Lakes Pediatric Cardiology PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Great Lakes Pediatric Cardiology PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Pediatric Medicine) reassigns their Medicare billing to Great Lakes Pediatric Cardiology PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Great Lakes Pediatric Cardiology PLLC accept?
Health plans from Blue Care Network of Michigan list Great Lakes Pediatric Cardiology PLLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Great Lakes Pediatric Cardiology PLLC was last updated on June 29, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Great Lakes Pediatric Cardiology, Pllc · NPI 1972293967
Pediatric Cardiology organization in Sterling Heights, Michigan. Organization record, active in the CMS NPPES registry since May 11, 2023.
## Identity
- **NPI:** 1972293967 (Entity type: Organization)
- **Enumerated:** May 11, 2023
- **Primary specialty:** Pediatrics - Pediatric Cardiology · taxonomy 2080P0202X
- **Legal business name:** Great Lakes Pediatric Cardiology Pllc
- **Also known as:** Great Lakes Pediatric Cardiology (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Ismael Gonzalez Rangel, PEDIATRIC CARDIOLOGIST
## Practice location
- **Address:** 43200 DEQUINDRE RD STE 105, Sterling Heights, MI 48314-1707
- **Phone:** (248) 780-9490
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Pediatric Medicine) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** June 29, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1972293967) · Data from the CMS NPPES public registry.